• Title/Summary/Keyword: Analysis & Design

Search Result 49,023, Processing Time 0.081 seconds

Analysis of Knowledge and Competency for the Fourth Industrial Revolution Based on Anderson's Revision of Bloom's Taxonomy: Focused on Achievement Standard in the 2015 revised Practical Arts(Technology·Home Economics) (Bloom의 신교육목표 분류체계에 기초한 4차 산업혁명 시대에 요구하는 지식과 역량 분석: 2015 개정 실과(기술·가정) 교육과정의 가정과 성취기준을 대상으로)

  • Yang, Ji Sun;Lee, Gyeong Suk
    • Journal of Korean Home Economics Education Association
    • /
    • v.30 no.3
    • /
    • pp.129-149
    • /
    • 2018
  • This study has attempted to analyze the achievement standards in the 2015 revised curriculum, based on the revision of Bloom's Taxonomy and aims to identify the knowledge and required competencies in the fourth industrial era. The results of this study are as follows: First, the knowledge dimensions was the highest 'metacognitive knowledge' in middle school, while 'factual knowledge' was the highest in high school, and 'knowledge of specific details and elements' was the highest subtype of all of the knowledge dimensions. The dimensions of the cognitive process, such as the terms 'apply' and 'analyze' in middle school, as 'understand' and 'evaluate' in high school have been treated inattentively. Second, the knowledge dimension and the cognitive process dimension according to key concepts display the metacognitive knowledge and 'understand' in development, the conceptual knowledge and 'understand' in relationship. While the 'metacognitive knowledge' and 'apply' in life culture, the 'procedural knowledge' and 'evaluate' in safety, the 'factual knowledge' and 'apply' in management and the 'metacognitive knowledge' and 'understand' in life design were extremely high. Third, the verbs used in the achievement standards displayed as 'explore', 'understand', 'analyze', 'practice', 'suggest', 'recognize' and 'evaluate'. Since the statement of the action verb is the very basis for determining the performance process, specific competencies may be achieved by reflecting on the actual achievement standards. These standards should provide us with a effective cognitive process for to understand a learner's performance skills and support the direction of the education required, through a strategy that refines the connection between content elements and functions and develop their competences for the future.

Developing Systems Thinking-based STEAM Programs and Analyzing its Effects on Middle School Students (중학생을 위한 시스템 사고 기반 STEAM 교육 프로그램의 개발 및 효과 분석)

  • Kim, Yuran;Jeon, Jaedon;Eom, Jooyoung;Lee, Hyonyong
    • Journal of the Korean earth science society
    • /
    • v.41 no.1
    • /
    • pp.75-91
    • /
    • 2020
  • The purposes of this study are 1) to develop a pre-education program for teaching the basic concepts of systems thinking and STEAM program based on systems thinking and 2) to investigate the effects of the program on middle school students' systems thinking. The subjects were 4 seventh-graders and 4 ninth-graders in a middle school located in the province of Gyeongsangbuk-do. Data related to students' systems thinking was analyzed using the rubrics developed by Hung(2008). The results were reviewed by experts to verify the validity of the rubrics and the reliability of students' system thinking. In addition, the data analyzed with the rubrics, students' awareness of systems thinking, word associations, causal maps and interviews were systematically analyzed to investigate the effects of the program on students' systems thinking. The findings of this study were as follows: First, a pre-education program and teachers' guidebook for teaching and learning the concept of systems thinking and causal maps were developed. The pre-education program consisted of familiar TV entertainment program-Infinite Challenge (Muhandojeon)-with a theme of Global Warming. Second, a STEAM education program based on systems thinking which was composed of 5 steps: Analysis-Design-Build-Assessment-Systems thinking. The major theme of the program was an air extinguisher. The developed STEAM education program had positive effects on improving middle school students' systems thinking abilities such as understanding systems, relations within a system and system generalization. Therefore, it was concluded that the STEAM program could be instrumental for cultivating students' STEAM literacy with improved systems thinking.

Quality Standardization and Isoflavone Glycoside Research of in Buseoktae(Yeongju bean) Cheonggukjang for Business Use from Yeongju Bean (영주 부석태 청국장시료의 이소플라본 배당체 탐색과 청국장의 품질 표준화)

  • Choi, Eun-Young;Yu, Jin-Hyeon;An, Hui-Jeong
    • Culinary science and hospitality research
    • /
    • v.22 no.2
    • /
    • pp.13-28
    • /
    • 2016
  • This study performed quantitative analysis of isoflavone glycoside contents on Buseoktae, Daewon, Wooram beans and cheonggukjang made of Buseoktae beans from the LC/MS/MS. Also, the experiment carried out by means of RSM(response surface methodology), which included 10 experimental points for the two independent variables addition(40, 55, 70 g) and time(2, 3, 4 min) from the beginning point to boil of cheonggukjang. These were optimized using a Face-centered central composite design. Daidzein contents were $212.16{\mu}g/mL$ in Buseoktae, $212.21{\mu}g/mL$ in daewon, $158.54{\mu}g/mL$ in wooram beans. Genistein contents were $318.84{\mu}g/mL$ in Buseoktae, $310.50{\mu}g/mL$ in daewon, $262.71{\mu}g/mL$ in wooram beans. Total isoflavone contents were $532.50{\mu}g/mL$ in Buseoktae, $524.19{\mu}g/mL$ in Daewon, $422.71{\mu}g/mL$ in Wooram beans. Isoflavone contents of Buseoktae and Daewon were quite similar, relatively contents of Wooram beans were low. Total isoflavone contents of Buseoktae cheonggukjang (for business use) was $430.10{\mu}g/mL$ in A ($32^{\circ}C$, 96 h fermentation), $460.09{\mu}g/mL$ in B ($36{\sim}40^{\circ}C$, 30 h fermentation), $417.46{\mu}g/mL$ in C cheonggukjang($36{\sim}38^{\circ}C$, 72 h fermentation), B cheonggukjang was just a bit more than A, C cheonggukjang. The estimated response surfaces confirmed that the amount and time had significant effects on taste. The optimum condition of Buseoktae cheonggukjang taste was predicted to be 55.20 g addition at 2.92 min.

A Study on the Environment for Lowbirth Weight Infants in Neonatal Intensive Care Unit in the United States (신생아집중간호단위 환경과 저체중출생아의 반응에 대한 연구)

  • Han Kyung Ja
    • Child Health Nursing Research
    • /
    • v.4 no.2
    • /
    • pp.159-176
    • /
    • 1998
  • In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

  • PDF

An Analysis of Nursing education Research in China : 1990-1998 (중국 간호교육관련 연구실태 분석)

  • Ko Il-Sun;Li Chun-Yu;Kim Jing-Ai
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.5 no.2
    • /
    • pp.177-190
    • /
    • 1999
  • This study has been conducted on the basis of the literature review of Nursing Education Research in China from 1990 through August 1998. Its purpose was to support the basic data of nursing education which is risen as major revolutionary of nursing in China and those for exchange of information between Korea-China nursing education. It is retrospective and descriptive research analyzing one hundred eighty articles published in The Journal of China Nursing. The results of the study were as follows. 1. Only 33.3% of the professors of Technical Nursing School who have played of major role of nursing education in China have carried out the study related to nursing education. Baccalaureate program professors have marked 22.2% of all studies, and diploma program professors have done 12.2% of all. Therefore, the professors of above the diploma program have done total 44.4%. It explains that the professors of baccalaureate and diploma programs have done more studies related to nursing education than those of Technical Nursing School. 2. In terms of the study design, most of the studies(38.8%) were case studies introducing the curriculum contents that were done at education institutions. And then, 28.5% were reviewing the articles, and 15.6% were descriptive studies. 3. In terms of the content of the study, 38.3% were relevant to education of Technical Nursing School, 15.0% were about baccalaureate education, and 10.4% is about diploma. 4. To analyze the specific contents of the studies ; a. In baccalaureate program, human resources (professor or teaching), course extension, lab, classes, teaching method, education philosophy, goal of education, evaluation method, and human resource development were included. b. In diploma program, teaching contents evaluation method, teaching method, and educational system were included c. In the technical school, there were qualification of professors , teaching method, evaluation method, opening the courses, teaching contents, goal of education and so on. d. Beyond these, there were practice guidance and appraisement, teaching method, and opening new courses which were not specially indicated as educational curriculum and score management as continuing education. What is above tell us that the study regarding development of university system has been progressed actively and widely. It has been for the effort of revolution which based on the China government force to reform of nursing education process during last 10 years. On the base of the result, we suggest the following questions and the alternatives. 1) Since most articles are case studies related to teaching methods and the others doesn't propose the research method. the study which is applied more exact research method is needed. 2) No study is regarding social change and health policy. Because University program, founded in 1983 is on the beginning point, the research about curriculum have to be taken as a top priority as well as to reflect social needs which are based on social changes and national health policy 3) Only one review article study tells nursing Human resource. To appear in large numbers in nursing manpower, avoid the present hospital nurses training system. Then, the study for manpower development which is able to accomplish in many fields has to be advanced. 4) Most studies did not have literature review processes, so it was impossible for researcher to know the past study tendency and there is no relation among studies as to same subject, the education about research method is needed.

  • PDF

A Study on the Effects of User Participation on Stickiness and Continued Use on Internet Community (인터넷 커뮤니티에서 사용자 참여가 밀착도와 지속적 이용의도에 미치는 영향)

  • Ko, Mi-Hyun;Kwon, Sun-Dong
    • Asia pacific journal of information systems
    • /
    • v.18 no.2
    • /
    • pp.41-72
    • /
    • 2008
  • The purpose of this study is the investigation of the effects of user participation, network effect, social influence, and usefulness on stickiness and continued use on Internet communities. In this research, stickiness refers to repeat visit and visit duration to an Internet community. Continued use means the willingness to continue to use an Internet community in the future. Internet community-based companies can earn money through selling the digital contents such as game, music, and avatar, advertizing on internet site, or offering an affiliate marketing. For such money making, stickiness and continued use of Internet users is much more important than the number of Internet users. We tried to answer following three questions. Fist, what is the effects of user participation on stickiness and continued use on Internet communities? Second, by what is user participation formed? Third, are network effect, social influence, and usefulness that was significant at prior research about technology acceptance model(TAM) still significant on internet communities? In this study, user participation, network effect, social influence, and usefulness are independent variables, stickiness is mediating variable, and continued use is dependent variable. Among independent variables, we are focused on user participation. User participation means that Internet user participates in the development of Internet community site (called mini-hompy or blog in Korea). User participation was studied from 1970 to 1997 at the research area of information system. But since 1997 when Internet started to spread to the public, user participation has hardly been studied. Given the importance of user participation at the success of Internet-based companies, it is very meaningful to study the research topic of user participation. To test the proposed model, we used a data set generated from the survey. The survey instrument was designed on the basis of a comprehensive literature review and interviews of experts, and was refined through several rounds of pretests, revisions, and pilot tests. The respondents of survey were the undergraduates and the graduate students who mainly used Internet communities. Data analysis was conducted using 217 respondents(response rate, 97.7 percent). We used structural equation modeling(SEM) implemented in partial least square(PLS). We chose PLS for two reason. First, our model has formative constructs. PLS uses components-based algorithm and can estimated formative constructs. Second, PLS is more appropriate when the research model is in an early stage of development. A review of the literature suggests that empirical tests of user participation is still sparse. The test of model was executed in the order of three research questions. First user participation had the direct effects on stickiness(${\beta}$=0.150, p<0.01) and continued use (${\beta}$=0.119, p<0.05). And user participation, as a partial mediation model, had a indirect effect on continued use mediated through stickiness (${\beta}$=0.007, p<0.05). Second, optional participation and prosuming participation significantly formed user participation. Optional participation, with a path magnitude as high as 0.986 (p<0.001), is a key determinant for the strength of user participation. Third, Network effect (${\beta}$=0.236, p<0.001). social influence (${\beta}$=0.135, p<0.05), and usefulness (${\beta}$=0.343, p<0.001) had directly significant impacts on stickiness. But network effect and social influence, as a full mediation model, had both indirectly significant impacts on continued use mediated through stickiness (${\beta}$=0.11, p<0.001, and ${\beta}$=0.063, p<0.05, respectively). Compared with this result, usefulness, as a partial mediation model, had a direct impact on continued use and a indirect impact on continued use mediated through stickiness. This study has three contributions. First this is the first empirical study showing that user participation is the significant driver of continued use. The researchers of information system have hardly studies user participation since late 1990s. And the researchers of marketing have studied a few lately. Second, this study enhanced the understanding of user participation. Up to recently, user participation has been studied from the bipolar viewpoint of participation v.s non-participation. Also, even the study on participation has been studied from the point of limited optional participation. But, this study proved the existence of prosuming participation to design and produce products or services, besides optional participation. And this study empirically proved that optional participation and prosuming participation were the key determinant for user participation. Third, our study compliments traditional studies of TAM. According prior literature about of TAM, the constructs of network effect, social influence, and usefulness had effects on the technology adoption. This study proved that these constructs still are significant on Internet communities.

The Effects of the Breast Self-Examination Participant Education program on Breast Self-Examination Compliance and Health Promoting Behaviors in Adult Women (유방 자가 검진 참여 교육 프로그램이 유방 자가 검진 이행과 건강 증진 행위에 미치는 영향)

  • Park, Eun-Hwa;Ryu, Eun-Jung;Choi, Kyung-Sook
    • Asian Oncology Nursing
    • /
    • v.3 no.2
    • /
    • pp.133-144
    • /
    • 2003
  • This study is carrying out a before and after experiment design for the non-equal comparative group to identify the effects of the breast self-examination education on breast self-examination participant education compliance and health promotion in women. The subject of this study was 58 women residing in Chungju. Their age ranged from 20 to 40. These women were not pregnant or did not breast feed, as well as they did not have any breast disease, at the time of survey. They were available for the response to the questionnaires, and understood the purpose of this study. They also agreed to participate in the study, and responded to the 3rd time questionnaires to the end. Thus, brochures and lectures were provided side by side to a group of 19 of those women, and only brochures were provided to another group of 39 of those women. With regard to education, a brochure and a program using a breast model were applied. Then, the frequency of the breast self examination compliance, breast self examination capability and the relations between the breast self examination and activities to promote health were measured, before the education, after 4 weeks of education and after 12 weeks of education. Before education and after 4 weeks of education. I collected the questionnaires myself visiting them, and after 12 weeks of education, the questionnaires were collected by mail. In relation to the study tool, the breast self examination activity was measured by two measuring tools: breast self examination activity frequency and breast self examination compliance capability. As for the frequency, the number of self examination for the period of 3 months, before the questionnaire survey, was measured in the form of self report. In relation to the tool to measure the breast self examination capability, the BSEPRI tool, which was developed by Wood in 1994, was used. Here, as the score was higher, the capability was indicated to be higher. The translated and revised version of Health Promoting Lifestyle Profile II (Walker, Sechrist & Pender. 2002) was used as a tool for health promotion. As the measured score was higher, the health promoting activity was indicated to be higher. The results of this study were as follows: 1. As a result of checking the breast self examination compliance frequency between the experiment group that received the breast self examination participant education and the comparative group that did not receive the education, there was a significant difference in interaction between groups by time, as time passed by. 2. As a result of checking the breast self examination compliance capability between the experiment group and the comparative group, there was a significant difference in interaction between groups by time, as time passed by. 3. As a result of carrying out a repetitive measurement analysis, between the experiment group that received the breast self examination education and the comparative group that did not receive the education, which was carried out to validate the hypothesis that the former would have higher health promoting activities than the latter, there was no significant difference after the breast self examination education was conducted.

  • PDF

Effect of Shading Level on Growth and Morphological Characteristics of Ligularia fischeri Seedling (차광수준이 곰취 유묘의 생장 및 형태적 특성에 미치는 영향)

  • Song, Ki Seon;Jeon, Kwon Seok;Kim, Chang Hwan;Yoon, Jun Hyuck;Park, Yong Bae;Kim, Jong Jin
    • Journal of Bio-Environment Control
    • /
    • v.23 no.2
    • /
    • pp.88-94
    • /
    • 2014
  • This study was carried out to survey the early growth characteristics of Ligularia fischeri, plants of half-shaded grounds, primarily used as functional wild edible greens and examine its shading treatment to transplant seedling. The shading treatment was regulated with the shading level(full sunlight, 35%, 50%, 75%, and 95% of full sunlight). According to the experiment, the height was the highest under 75% of shading (17.3 cm), and root diameter was the highest under full sunlight (2.13 mm). It was found that fresh weight (leaf, shoot, root and whole) was the highest (1.784 g, 1.330 g, 0.791 g, 3.905 g respectively ) under 50% of shading. In case of dry weight, leaf, shoot and whole dry weight were surveyed the highest under 35% of shading, and root dry weight was the highest under full sunlight. It was found that S/R ratio and moisture contents (leaf, shoot, root and whole) were the highest under 95% of shading. Leaf area was the highest under 50% of shading ($39.3cm^2$) and the higher shading level, the higher SLA and LAR. It was surveyed that the higher shading level, the thinner leaf thickness. In case of root characteristics, it was showed that the relatively high height growth under 35%~75% of shading, excepting 95% of shading. As a result of surveying the whole experiment, it is concluded that the early growth of L. fischeri is more effective in producing it under 50% of shading.

Quality Dimensions Affecting the Effectiveness of a Semantic-Web Search Engine (검색 효과성에 영향을 미치는 시맨틱웹 검색시스템 품질요인에 관한 연구)

  • Han, Dong-Il;Hong, Il-Yoo
    • Asia pacific journal of information systems
    • /
    • v.19 no.1
    • /
    • pp.1-31
    • /
    • 2009
  • This paper empirically examines factors that potentially influence the success of a Web-based semantic search engine. A research model has been proposed that shows the impact of quality-related factors upon the effectiveness of a semantic search engine, based on DeLone and McLean's(2003) information systems success model. An empirical study has been conducted to test hypotheses formulated around the research model, and statistical methods were applied to analyze gathered data and draw conclusions. Implications for academics and practitioners are offered based on the findings of the study. The proposed model includes three quality dimensions of a Web-based semantic search engine-namely, information quality, system quality and service quality. These three dimensions each have measures designed to collectively assess the respective dimension. The model is intended to examine the relationship between measures of these quality dimensions and measures of two dependent constructs, including individuals' net benefit and user satisfaction. Individuals' net benefit was measured by the extent to which the user's information needs were adequately met, whereas user satisfaction was measured by a combination of the perceived satisfaction with search results and the perceived satisfaction with the overall system. A total of 23 hypotheses have been formulated around the model, and a questionnaire survey has been conducted using a functional semantic search website created by KT and Hakia, so as to collect data to validate the model. Copies of a questionnaire form were handed out in person to 160 research associates and employees working in the area of designing and developing semantic search engines. Those who received the form, 148 respondents returned valid responses. The survey form asked respondents to use the given website to answer questions concerning the system. The results of the empirical study have indicated that, of the three quality dimensions, information quality was found to have the strongest association with the effectiveness of a Web-based semantic search engine. This finding is consistent with the observation in the literature that the aspects of the information quality should serve as a basis for evaluating the search outcomes from a semantic search engine. Measures under the information quality dimension that have a positive effect on informational gratification and user satisfaction were found to be recall and currency. Under the system quality dimension, response time and interactivity, were positively related to informational gratification. On the other hand, only one measure under the service quality dimension, reliability was found to have a positive relationship with user satisfaction. The results were based on the seven hypotheses that have been accepted. One may wonder why 15 out of the 23 hypotheses have been rejected and question the theoretical soundness of the model. However, the correlations between independent variables and dependent variables came out to be fairly high. This suggests that the structural equation model yielded results inconsistent with those of coefficient analysis, because the structural equation model intends to examine the relationship among independent variables as well as the relationship between independent variables and dependent variables. The findings offer some useful implications for owners of a semantic search engine, as far as the design and maintenance of the website is concerned. First, the system should be designed to respond to the user's query as fast as possible. Also it should be designed to support the search process by recommending, revising, and choosing a search query, so as to maximize users' interactions with the system. Second, the system should present search results with maximum recall and currency to effectively meet the users' expectations. Third, it should be capable of providing online services in a reliable and trustworthy manner. Finally, effective increase in user satisfaction requires the improvement of quality factors associated with a semantic search engine, which would in turn help increase the informational gratification for users. The proposed model can serve as a useful framework for measuring the success of a Web-based semantic search engine. Applying the search engine success framework to the measurement of search engine effectiveness has the potential to provide an outline of what areas of a semantic search engine needs improvement, in order to better meet information needs of users. Further research will be needed to make this idea a reality.

GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH) (난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구)

  • Kim, Mee-Ran;Song, In-Ok;Yeon, Hye-Jeong;Choi, Bum-Chae;Paik, Eun-Chan;Koong, Mi-Kyoung;Song, Il-Pyo;Lee, Jin-Woo;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.26 no.2
    • /
    • pp.163-170
    • /
    • 1999
  • Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

  • PDF